Wednesday, June 6, 2012

Health and Fitness Are Not The Same

Few would argue the fact that regular physical activity has been shown to reduce the risk of certain chronic diseases, including hypertension (high blood pressure), stroke, coronary artery disease, type 2 diabetes, colon cancer and osteoporosis in addition to improving one's quality of life. According to the Canadian Society of Exercise Physiology, to reduce the risk of chronic disease, it is recommended that adults accumulate at least 60 minutes of moderate-intensity physical activity on most, preferably all, days of the week. At this point you are likely wondering how you could possibly perform 60 minutes of physical activity consecutively, let alone find a free hour in your busy day. Before these thoughts cause you to stop reading this article, let me emphasize the magnificence of CSEP's recommendation and what researchers have discovered about exercise. The key to health and chronic disease prevention is the accumulation of daily physical activity. Further notice that the specifics of the type of physical activity are also missing. Sure, some activities are indeed better than others, but the term 'better' is specific to one's goals. For cardiovascular health, activities that use large muscle mass and rhythmic motions such as walking, biking and swimming are great, but this doesn't mean other forms of physical activity aren't effective. In fact, any activity that gets you moving will do just fine. I have intentionally been avoiding the use of the term exercise. Exercise is typically associated with pain, sweat, and in some cases misery! By using the term physical activity we encompass things such as gardening, washing the car, dancing, playing with children and even housework. To understand why these activities, even in small amounts are great for our health we must first understand that multiple short bouts of physical activity provide all the health benefits of a single long bout of physical activity.

How can this be? If we separate the terms health and fitness this will make more sense. Health is defined by the World Health Organization as 'a total physical and psychological sense of wellbeing and not merely the absence of disease'. Fitness on the other hand is tied closely to physical performance and sport such as the ability to run quickly or for long periods of time. A regular walker or hiker can therefore be every bit as healthy as a marathon runner despite lacking the fitness attributes that allow the runner to complete a race in a limited amount of time. A more concrete example of this would be comparing blood pressure and blood cholesterol between runners and walkers. Assuming that other lifestyle, diet and genetics are similar, the results of these tests would be similar and doctors would give each a clean bill of health with respect to these measures.

How does one train for health or fitness? Different intensities and types of exercise confer different benefits. Vigorous physical activity (running and sprinting) provides greater benefits for physical fitness than does moderate physical activity (walking) and burns more calories per unit of time. Resistance exercise (such as weight training, using weight machines, and resistance band workouts) increases muscular strength and endurance and maintains or increases muscle mass. These benefits are seen in adolescents, adults, and older adults who perform resistance exercises on 2 or more days per week. Also, weight-bearing exercise has the potential to reduce the risk of osteoporosis by increasing peak bone mass during growth, maintaining peak bone mass during adulthood, and reducing the rate of bone loss during aging. In addition, regular exercise can help prevent falls, which is of particular importance for older adults.

It is important to recognize that the intensity of exercise is relative to the individual and not the activity. Thus brisk walking for an inactive individual with excess weight may be the same relative intensity as jogging for an avid runner. Thus a heavier individual should expect to experience elevated breathing and heart rate at lower intensities than a lighter or more fit individual.

The barrier often given for a failure to be physically active is lack of time. Setting aside 60 consecutive minutes each day for planned exercise is one way to obtain physical activity, but it is not the only way. Physical activity may include short bouts (10-minute bouts) of moderate-intensity activity. The accumulated total is what is important-both for health and for weight management. Physical activity can be accumulated through three to six 5-10 minute bouts over the course of a day. Consider incorporating both longer bouts and shorter accumulated bouts of activity into your day to increase your odds of achieving 60 minutes physical activity daily.

Pedometers are great for measuring the accumulation of physical activity. It does not matter if physical activity comes from house hold chores, a walk, a hike or a run. Further, a pedometer provides motivation, reminds us to spend less time sitting and rewards us for all activity. Remember, what matters is accumulation of physical activity and every step counts. Changing our minds about what counts as exercise can be motivating, rewarding and when you realize that all activity counts, you might just have the best kept yard and cleanest house on the block!